Procedure

What is it?

Advantages

Disadvantages

Hysterectomy

·   Surgical removal of the uterus. 

·   Expect a hospital stay and a recovery period. 

· Fibroids never come back because the uterus is removed. 

·   Reproductive potential is lost.  Other side effects possible. 

·   Recovery time is typically several weeks.

Abdominal myomectomy

·   Removal of one or more of the fibroids with open abdominal surgery.

· Preserves the uterus and cervix.

·   A re-occurrence of the fibroid symptoms is possible if new fibroids grow. 

Laparoscopic or hysteroscopic myomectomy

·   One or more of the fibroids are removed using laparoscopic or endoscopic techniques.

· Less invasive than open abdominal myomectomy, fibroids can be removed via abdominal endoscope or the cervix/vagina.

·   Not suitable for larger, multiple, or deep fibroids. 

Uterine artery embolization

·   The uterine artery is blocked with small particles; the fibroid is starved of its blood supply.

· Symptom relief with shorter hospital stay than hysterectomy or myomectomy.

·   Risks include radiation, premature menopause, serious infection, bleeding and embolization of other than the fibroids.

Magnetic Resonance guided Focused Ultrasound

·   The use of focused ultrasound waves to heat and destroy fibroid tissue.  MRI images are used for treatment planning and feedback.

· No surgical incision required.  No radiation; quick return to normal life.

·   Fibroid recurrence not proven.  Not suitable for persons contraindicated for MRI.

Hormone therapy

·   A drug treatment that causes fibroid shrinkage.

· Non-surgical, conservative method of fibroid treatment.

·   Treatment is only effective for 6-12 months. 

·   Causes menopausal symptoms. 

·   May result in rapid return of symptoms after stopping treatment. 

Watchful waiting

·   No treatment.

·   Monitoring for any progression of symptoms. 

· Sometimes fibroid symptoms diminish with menopause. 

·   Fibroids can continue to grow with an increase in symptoms. 

·   Fibroids beyond a certain size may require surgery.